Empowering Earthquake Resilient Healthcare Systems: A Comprehensive Policy Initiative

Advocate for Comprehensive, Safe, and Earthquake-Resilient Healthcare Systems

Proposed Policy Statement:

The Earthquake Engineering Research Institute EERI calls upon every earthquake-prone community in the United States to enhance its seismic safety and resilience by incorporating comprehensive planning and design strategies into its healthcare systems. These systems are essential for providing care during both regular operations and in emergency situations, ensuring the welfare of those already receiving medical attention as well as addressing additional needs resulting from an earthquake event.

Background:

The U.S. healthcare system faces significant challenges when it comes to being adequately prepared for earthquakes that range from moderate to severe intensity. The 1971 San Fernando earthquake highlighted the vulnerability of hospitals, resulting in substantial damage and collapse incidents that underscored in hospital resilience design. Even after reconstruction efforts post-earthquake, the 1994 Northridge event demonstrated further challenges through nonstructural damages, leading to temporary inaccessibility of some healthcare facilities.

While advancements have been made since then regarding seismic regulations focused on hospital resilience, implementation hurdles continue to pose risks to both medical staff and patients alike. Despite progress at the local level, many states and regions do not fully adopt or implement these improvements, especially within medium- and high-seismicity areas. The federally-funded Health Care Coalitions HCCs, which coordinate activities among healthcare organizations for disaster preparedness, are often underfunded and may lack partnerships essential for promoting systemic seismic resilience.

Moreover, existing building codes fl to effectively identify health care facilities at risk of collapse during major earthquakes - those that will not be avlable after the event but can cause significant injury inside. This highlights a need for more stringent regulation by governing bodies and coordinated regional earthquake preparedness planning that encompasses safety standards, funding mechanisms, facility assessment programs, and inclusive healthcare sector partnerships.

Immediate Actions:

1. Accreditation and Licensing Requirements:

   • Allocate federal, state, and county funds to assess the seismic resilience of health care suppliers and providers.

   • Recognize that improving seismic resilience is costly and may lead to financial strn on rural and underserved communities. Coupled funding assistance should accompany regulatory changes at all levels of government, including reimbursement agencies and accreditors.

   • Encourage private, foundation, and local sources of funding for health care facilities in areas with limited resources.

2. Improved Risk Assessment:

   • Establish appropriate American Society of Civil Engineers ASCE risk categories for critical non-hospital health care facilities to ensure surge capacity and functionality post-earthquake events. These should include structural and nonstructural components.

   • Incorporate these risk categories into state-level healthcare facility licensure guidelines to guide safer design practices.

3. Funding Support:

   • Restore funding sources essential for healthcare and public health emergency preparedness e.g., ASPR’s Hospital Preparedness Program, CDC’s Public Health Emergency Preparedness Cooperative Agreement to peak 2004 levels or beyond.

   • Create new federal funding streams dedicated to facility-level earthquake strengthening efforts that explicitly address the integrity of healthcare buildings as a pre-condition for receiving funds.

4. Ancillary Facilities and Non-Hospital Providers:

   • Ensure ancillary facilities and non-hospital health service providers have access to local, state, and federal funding opportunities for seismic retrofits, preparedness planning, and contingency plans.

5. Community Involvement in Planning:

   • Integrate community feedback into preparedness and mitigation plans through workshops and tools like the National Institute of Standards and Technology NIST community resilience planning guide.

   • Coordinate seismic preparedness activities among hospitals, healthcare coalitions, state and regional entities to ensure cohesive response and recovery plans.

6. Partnership with Engineering Experts:

   • Formalize arrangements between hospitals and state or federal agencies for engineers and facility experts to assist in damage assessment and reoccupancy determination following earthquakes, similar to San Francisco's Building Occupancy Resumption Program BORP.

:

The Earthquake Engineering Research Institute underscores the critical role of healthcare systems in disaster management. By advocating for comprehensive, safe, and earthquake-resilient strategies, communities can better prepare for potential seismic events, ensuring continuous care delivery while protecting vulnerable populations.

For more information or to join our efforts:

• Visit our website

• Contact us at [email protected]

Earthquake Engineering Research Institute EERI

499 14th Street, Suite 220

Oakland, CA 94612

Phone: +1-510-451-0905

Fax: +1-510-451-5411

This policy proposal is the property of Earthquake Engineering Research Institute EERI and may not be reproduced or distributed without permission.

: This information is and should not be taken as legal advice.
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